Cargando…
Incidence and risk factors for post-penetrating keratoplasty glaucoma: A systematic review and meta-analysis
OBJECTIVES: To establish the incidence and risk factors for post penetrating keratoplasty glaucoma (PKKG). METHODS: Studies published between 1947 and 2016 regarding penetrating keratoplasty (PK) were identified using an electronic search and reviewed. For search purpose, PKKG was defined as ocular...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400257/ https://www.ncbi.nlm.nih.gov/pubmed/28430806 http://dx.doi.org/10.1371/journal.pone.0176261 |
_version_ | 1783230798363623424 |
---|---|
author | Wu, Suqian Xu, Jianjiang |
author_facet | Wu, Suqian Xu, Jianjiang |
author_sort | Wu, Suqian |
collection | PubMed |
description | OBJECTIVES: To establish the incidence and risk factors for post penetrating keratoplasty glaucoma (PKKG). METHODS: Studies published between 1947 and 2016 regarding penetrating keratoplasty (PK) were identified using an electronic search and reviewed. For search purpose, PKKG was defined as ocular hypertension (> 21mmHg) after PK. The incidence and risk factors of PKKG were extracted for all studies. Pooled incidence, odd ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: Thirty studies reporting on 27146 patients were included in the analysis of the incidence and risk factors for PKKG. Exact PKKG definitions used in the literature could be classified in to three subgroups: I, ocular hypertension (> 21mmHg) after PK; II, I plus > 4 weeks medical treatment required; III, II plus treatment escalation among patients with preexisting glaucoma. Overall (Definition I) pooled incidence in all studies was 21.5% (95% CI 17.8%, 25.7%). The incidence varied according to different definitions. The highest incidence value was found when only studies using Goldmann tonometer were included (22.5%), while the lowest incidence was found when a strict definition was used and steroid-induced PPKG was excluded (12.1%). The incidence was higher in patients with preexisting glaucoma, bullous keratopathy (BK), aphakia, pseudophakia, failed graft, and surgical indication of trauma. A triple procedure (combined PK with extra capsular cataract extraction and intraocular lens implantation) was not identified as being associated with the increased risk for PKKG. CONCLUSIONS: The overall pooled incidence of PKKG was 21.5%, but it varied according to the criteria used to define the presence of PPKG. Strong risk factors for PKKG included preexisting glaucoma and aphakia, while modest predictors included pseudophakia, regrafting, and preoperative diagnosis like BK and trauma. There may not be sufficient evidence to identify a significant association between a triple procedure and PKKG. |
format | Online Article Text |
id | pubmed-5400257 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-54002572017-05-12 Incidence and risk factors for post-penetrating keratoplasty glaucoma: A systematic review and meta-analysis Wu, Suqian Xu, Jianjiang PLoS One Research Article OBJECTIVES: To establish the incidence and risk factors for post penetrating keratoplasty glaucoma (PKKG). METHODS: Studies published between 1947 and 2016 regarding penetrating keratoplasty (PK) were identified using an electronic search and reviewed. For search purpose, PKKG was defined as ocular hypertension (> 21mmHg) after PK. The incidence and risk factors of PKKG were extracted for all studies. Pooled incidence, odd ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: Thirty studies reporting on 27146 patients were included in the analysis of the incidence and risk factors for PKKG. Exact PKKG definitions used in the literature could be classified in to three subgroups: I, ocular hypertension (> 21mmHg) after PK; II, I plus > 4 weeks medical treatment required; III, II plus treatment escalation among patients with preexisting glaucoma. Overall (Definition I) pooled incidence in all studies was 21.5% (95% CI 17.8%, 25.7%). The incidence varied according to different definitions. The highest incidence value was found when only studies using Goldmann tonometer were included (22.5%), while the lowest incidence was found when a strict definition was used and steroid-induced PPKG was excluded (12.1%). The incidence was higher in patients with preexisting glaucoma, bullous keratopathy (BK), aphakia, pseudophakia, failed graft, and surgical indication of trauma. A triple procedure (combined PK with extra capsular cataract extraction and intraocular lens implantation) was not identified as being associated with the increased risk for PKKG. CONCLUSIONS: The overall pooled incidence of PKKG was 21.5%, but it varied according to the criteria used to define the presence of PPKG. Strong risk factors for PKKG included preexisting glaucoma and aphakia, while modest predictors included pseudophakia, regrafting, and preoperative diagnosis like BK and trauma. There may not be sufficient evidence to identify a significant association between a triple procedure and PKKG. Public Library of Science 2017-04-21 /pmc/articles/PMC5400257/ /pubmed/28430806 http://dx.doi.org/10.1371/journal.pone.0176261 Text en © 2017 Wu, Xu http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Wu, Suqian Xu, Jianjiang Incidence and risk factors for post-penetrating keratoplasty glaucoma: A systematic review and meta-analysis |
title | Incidence and risk factors for post-penetrating keratoplasty glaucoma: A systematic review and meta-analysis |
title_full | Incidence and risk factors for post-penetrating keratoplasty glaucoma: A systematic review and meta-analysis |
title_fullStr | Incidence and risk factors for post-penetrating keratoplasty glaucoma: A systematic review and meta-analysis |
title_full_unstemmed | Incidence and risk factors for post-penetrating keratoplasty glaucoma: A systematic review and meta-analysis |
title_short | Incidence and risk factors for post-penetrating keratoplasty glaucoma: A systematic review and meta-analysis |
title_sort | incidence and risk factors for post-penetrating keratoplasty glaucoma: a systematic review and meta-analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400257/ https://www.ncbi.nlm.nih.gov/pubmed/28430806 http://dx.doi.org/10.1371/journal.pone.0176261 |
work_keys_str_mv | AT wusuqian incidenceandriskfactorsforpostpenetratingkeratoplastyglaucomaasystematicreviewandmetaanalysis AT xujianjiang incidenceandriskfactorsforpostpenetratingkeratoplastyglaucomaasystematicreviewandmetaanalysis |